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- Title
Preoperative Loss of Knee Extension Affects Knee Extension Deficit in Patients After Anterior Cruciate Ligament Reconstruction.
- Authors
Yasui, Junichiro; Ota, Susumu; Kurokouchi, Kazutoshi; Takahashi, Shigeo
- Abstract
Background: Loss of knee extension (LOE) after anterior cruciate ligament reconstruction (ACLR) is associated with limited knee joint function and increased risk for knee osteoarthritis. Hypothesis: Preoperative LOE will affect postoperative LOE for up to 12 months after ACLR. Study Design: Cohort study; Level of evidence, 2. Methods: Included were patients who underwent anatomic ACLR between June 2014 and December 2018. In all patients, the postoperative rehabilitation protocol was the same. A heel height difference (HHD) ≥2 cm between the affected and the contralateral leg was used as a measure of LOE. Based on preoperative HHD, patients were divided into LOE and no-LOE groups. The HHD was reevaluated at 1, 3, 4, 6, 9, and 12 months postoperatively. Proportional hazards analysis was used, with the dependent variable being whether a postoperative HHD <2 cm was achieved; the independent variables being the presence or absence of preoperative LOE; and the adjusted variables being age, sex, time to surgery, and presence of meniscal sutures. Results: A total of 389 patients (208 female, 181 male; median age, 21.0 years) were included in the study. There were 55 patients in the LOE group and 334 patients in the no-LOE group. The incidence of LOE at 12 months after ACLR was 13.8% in the no-LOE group and 38.2% in the LOE group (P <.001), with an absolute risk difference of 24.4%. The hazard ratio for achieving postoperative HHD <2 cm was 2.79 for the LOE group versus the no-LOE group (P <.001). Conclusion: Patients with preoperative LOE were nearly 3 times more likely than those without LOE to have LOE at 12 months after ACLR.
- Subjects
PREOPERATIVE care; KNEE joint; KNEE osteoarthritis; RANGE of motion of joints; CONFIDENCE intervals; ANTERIOR cruciate ligament; AGE distribution; TIME; TENDONS; MANN Whitney U Test; RISK assessment; SEX distribution; INTRACLASS correlation; CHI-squared test; DESCRIPTIVE statistics; ANTERIOR cruciate ligament surgery; LONGITUDINAL method; HEEL (Anatomy); PROPORTIONAL hazards models; DISEASE risk factors
- Publication
Orthopaedic Journal of Sports Medicine, 2023, Vol 11, Issue 2, p1
- ISSN
2325-9671
- Publication type
Article
- DOI
10.1177/23259671231151410